Healthcare on a Shoestring: how will this affect medical negligence claims?

The sacred text of the government’s coalition agreement promised: “We will stop the top-down reorganisations of the NHS that have got in the way of patient care.” But now this pledge is broken. John Healey, shadow health secretary, this week exposed how new inflation figures show the NHS will suffer a real cut, alongside its most radically disruptive reorganisation.

The Guardian reports that many primary care trusts have heavy debts that they are expected to pay off fast, before handing over to GPs to commission all NHS services. PCTs are sending out letters ordering GPs not to refer patients for anything but urgent surgery. Surrey, Warwickshire, Lancashire and almost every other PCT is delaying surgery for hips, knees and even cataracts, sometimes until the new financial year. By banning GPs from referring, they avoid falling foul of Labour’s NHS rule requiring treatment within 18 weeks of GP referral.

What happens when PCTs save money? They pass their debts on to hospitals, which suddenly find their surgeons have fewer patients to treat and less money coming in. The only effective cost-saving is through strategic planning – to rationalise services into specialist hospitals, as with the life-saving stroke treatment re-organisations. However, the government is removing strategic health authorities.

The former Conservative health secretary, Stephen Dorrell has warned that no health service had ever achieved what is now being squeezed from the NHS, a 4% annual saving for four years.

This week health secretary Andrew Lansley ignored every red light to launch 52 pathfinder GP consortia, commissioning services for a quarter of the population. He claims they will “put patients at the heart of everything the NHS does”. Unfortunately, most consortia will be larger and more remote from patients than the PCTs they replace. One pathfinder is Great West Commissioning in West London, where GPs have contracted United Health to run its referrals.

Only a quarter of GPs in surveys express enthusiasm. Dr Clare Gerada, head of the Royal College of GPs, has been fiercely critical, warning that, if GPs are responsible for rationing, they will lose people’s trust.